Individual
MRS. MARIA SHEILA CHUPUICO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
251 US HWY 19 N, CAMILLA, GA 31730
(229) 336-8255
Mailing address
920 CAIRO RD, THOMASVILLE, GA 31792
(229) 336-8255
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT004636
GA
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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